The current status and influencing factors of care preparedness in primary caregivers of hospitalized children with acute leukemia / 中国实用护理杂志

Objective:To investigate the current status and influencing factors of care preparedness in primary caregivers of children with acute leukemia, so as to provide theoretical basis for targeted nursing intervention plans in the future.Methods:A total of 160 primary caregivers of children with acute leukemia in Hematology Hospital of the Chinese Academy of Medical Sciences recruited by convenient sampling were investigated by the general data questionnaire, the Preparedness for Caregiving Scale, the Herth Hope Index, the Family Caregiver Task Inventory and the Mishel Uncertainty in Illness Scale-Family Member Form. Descriptive analysis, Mann-Whitney U test, Kruskal-Wallis H test, Spearman rank correlation and multiple stepwise liner regression were used for statistical analysis. Results:One hundred and fifty-nine questionnaires were effectively collected, including 13 males and 146 females, aged (34.61 ± 8.60) years old. The total score of care preparedness, hope, uncertainty in illness, care ability for caregivers were (26.47 ± 7.53), (37.72 ± 4.11), (61.96 ± 17.02), (15.06 ± 12.94) points. The total score of care preparedness for caregivers was negatively correlated with the score of uncertainty in illness( r=-0.300, P<0.05), and positively correlated with the hope and care ability of main caregivers ( r=0.166, 0.254, both P<0.05). Caregivers′ uncertainty in illness, caregiver gender, availability of other caregivers, caregivers′ hope entered the multiple stepwise regression equation, which could explain 20.4% of the total variation of resilience. Conclusions:The preparation of the primary caregivers for children with acute leukemia is at a medium level. The primary caregivers who are male, who have insufficient knowledge of the disease, who have no co-caregivers, and who have low hope level should be focused on in clinical practice. Pertinent measures should be taken to improve care preparedness and care quality.

Modified Banxia Xiexintang for Treatment of Simple Obesity in Children with Syndrome of Stomach Hyperactivity and Spleen Stagnation： A Randomized Controlled Study / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy and safety of modified Banxia Xiexintang in treating simple obesity in children with the syndrome of stomach hyperactivity and spleen stagnation. MethodA randomized， double-blind， placebo-controlled study was conducted， in which 78 children with simple obesity due to stomach hyperactivity and spleen stagnation were randomized into an observation group （39 cases） and a control group （39 cases）. On the basis of diet and exercise intervention， the observation group received modified Banxia Xiexintang and the control group received placebo. The two groups were compared in terms of the therapeutic effect regarding TCM symptoms， body mass index （BMI）， waist circumference， hip circumference， obesity， and visual analogue scale of appetite after 2 months of treatment， and the treatment safety was observed. ResultAfter treatment， the response rate in the observation group was 88.89% （32/36）， which was higher than that （77.14%， 27/35） in the control group （Z=-2.301， P<0.05）. After 2 months of treatment， the body weight， BMI， waist circumference， hip circumference， and obesity decreased in both groups （P<0.05，P<0.01）. The TCM symptom scores and visual analogue scale scores of appetite in the observation group declined （P<0.05）. The control group showed decreased scores of TCM symptoms except gluttony and overeating （P<0.05）， declined scores of desire to eat， hunger， and willingness to eat declined （P<0.05）， and no significant change in the score of fullness before and after treatment. Compared with the control group， the observation group showed decreased total score of TCM symptoms， scores of primary and secondary TCM symptoms， body weight， BMI， waist circumference， hip circumference， obesity， and scores of desire to eat， hunger， and willingness to eat （P<0.05） and no significant difference in the score of fullness after treatment. No adverse reaction related to the drug application was observed during the treatment period. ConclusionModified Banxia Xiexintang can reduce the body weight， BMI， waist circumference， hip circumference， and obesity， improve the body shape， alleviate the symptoms， and enhance the therapeutic effect and compliance of children with simple obesity， being safe in clinical application.

Analysis of clinical features and genetic variant in a neonate with Au-Kline syndrome due to a de novo variant of the HNRNPK gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical phenotype and genetic basis of a neonate with Au-Kline syndrome (AKS).@*METHODS@#Clinical data and result of genetic testing of a neonate with AKS who was admitted to the Affiliated Provincial Children's Hospital of Anhui Medical University in January 2021 were retrospectively analyzed. Relevant literature was searched from the Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure and PubMed databases using key words "Au Kline syndrome", "Au-Kline syndrome", "HNRNPK" and "AKS". The research period was set as from January 1, 2000 to December 31, 2020.@*RESULTS@#The male newborn has manifested feeding difficulties, hypotonia, absence of the upper jaw to the uvula and facial dysmorphism. Trio-whole exome sequencing revealed that he has harbored a frameshift c.478dupA (p.Ile160AsnfsTer7) variant of the HNRNPK gene, which was varified by Sanger sequencing to have a de novo origin. The variant has not been included in the databases. Based on the guidelines from the American College of Medical Genetics and Genomics, the variant was rated as pathogenic (PVS1+PS2+PM2_Supporting). Literature retrieval has identified 14 children with AKS and de novo mutations of the HNRNPK gene. Their clinical manifestations have included growth and motor retardation, various degree of mental retardation, facial dysmorphism and a high frequency of congenital heart malformations.@*CONCLUSION@#The AKS in this child may be attributed to the c478dupA frameshifting variant of the HNRNPK gene. Diagnosis of AKS should be suspected for children with mental retardation and multiple congenital malformation syndromes including Kabuki syndrome.

Primary pleural diffuse large B-cell lymphoma:one case report and the review of literatures / 肿瘤

Objective:To describe the clinical characteristics and diagnosis and treatment process of a patient with primary pleural diffuse large B-cell lymphoma(DLBCL),in order to enhance the understanding of primary pleural DLBCL in clinical practice. Methods:The clinical characteristics and diagnosis and treatment process of a patient with primary pleural DLBCL was reported,and the related literatures were reviewed. Results:The patient complained of chest tightness and shortness of breath for over a year,and chest CT showed left pleural effusion and thickening of the left pleura.Thoracoscopic examination revealed extensive adhesions in the parietal pleura of the chest cavity,diffuse congestion of the parietal pleura,and multiple cauliflower-like new organisms.The pathological biopsy of the pleura diagnosed(left pleural mass)as DLBCL.After diagnosis,R-CHOP combined with Zebutinib treatment was performed for 4 cycles,and mid-term evaluation of chest CT showed significant regression of the tumor. Conclusion:Primary pleural DLBCL is a rare disease.It is easily to be misdiagnosed due to non-specific clinical and imaging manifestations.The final diagnosis depends ultimately on pathological biopsy,and thoracoscopy is the most effective method to confirm DLBCL.

Effect of Osteoking on lowering blood sugar and improving intestinal flora in db/db mice / 中国比较医学杂志

Objective To investigate the effects of Osteoking on hyperglycemia and regulating gut microbiota in db/db mice.Methods Wildtype mice were used as the control group,and db/db mice were randomly divided into model and Osteoking groups.After intragastric administration for 12 weeks,fasting blood glucose and serum glycosylated hemoglobin and insulin levels were measured,changes in intestinal microflora were determined,and functional pathways related to intestinal microflora in mice were predicted by 16S rDNA sequencing.Results Compared with the model group,Osteoking decreased fasting blood glucose(P<0.01),serum glycosylated hemoglobin(P<0.01),and the insulin resistance index(P<0.01),and increased insulin content(P<0.01)in db/db mice.Osteoking increased the abundance of beneficial intestinal microflora and decreased the abundance of harmful bacteria.Moreover,the abundance of Marvinbryantia was increased.Osteoking alleviated the decrease in metabolism of D-arginine and D-ornithine,sphingolipid,and galactose metabolism(P<0.05)and inhibited lysine degradation,the sulfur relay system,and propanoate metabolism(P<0.05).Conclusions Osteoking has hypoglycemic properties and improves the intestinal microflora imbalance in db/db mice.

Perioperative mechanical ventilation strategy for COVID-19 patients: Recommendation / 中国胸心血管外科临床杂志

@#Since December 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has gradually spread all over the world. With the implementation of class B infectious disease management policy for coronavirus disease 2019 (COVID-19), China has experienced a pandemic. For patients receiving a time-sensitive or emergency surgery, SARS-CoV-2 infection may increase the risk of postoperative pulmonary complications. An appropriate perioperative mechanical ventilation strategy, such as lung protective ventilation strategy, is particularly important for preventing postoperative pulmonary complications in patients undergoing general anesthesia. In addition, how to protect medical personnel from being infected is also the focus we need to pay attention to. This article will discuss the perioperative mechanical ventilation strategy for COVID-19 patients and the protection of medical personnel, in order to provide reference for the development of guidelines.

Clinical efficacy analysis of different interventional approaches for patent ductus arteriosus in children (≤7 years) / 中国胸心血管外科临床杂志

@#Objective    To explore the safety and effectiveness of different interventional approaches for the treatment of patent ductus arteriosus (PDA) in children. Methods    The children (≤7 years) who underwent interventional treatment for PDA from 2019 to 2020 in our hospital were retrospectively included. The patients were divided into 3 groups according to the procedures: a conventional arteriovenous approach group, a simple venous approach group, and a retrograde femoral artery approach group. The clinical efficacy of the patients was compared. Results     A total of 220 patients were included. There were 78 males and 142 females, with an average age of 3.21±1.73 years, weight of 14.99±5.35 kg, and height of 96.19±15.77 cm. The average diameter of the PDA was 3.35±1.34 mm. A total of 85 patients received a conventional arteriovenous approach, 104 patients received a simple venous approach, and 31 patients received a retrograde femoral artery approach. The diameter of PDA in the retrograde femoral artery group was smaller than that in the other two groups (3.44±1.43 mm vs. 1.99±0.55 mm; 3.69±1.17 mm vs. 1.99±0.55 mm, P<0.001); the contrast medium usage [40 (30, 50) mL vs. 20 (20, 30) mL; 35 (25, 50) mL vs. 20 (20, 30) mL, P≤0.001] and operation time [32 (26, 44) min vs. 25 (23, 30) min; 29 (25, 38) min vs. 25 (23, 30) min, P<0.05] in the simple venous approach group were significantly less or shorter than those in the other two groups; the length of hospital stay of the conventional arteriovenous group was longer than that in the other two groups [3 (3, 5) d vs. 4 (3, 6) d; 4 (3, 5) d vs. 4 (3, 6) d, P<0.05]. There was no significant difference in postoperative complications. Conclusion    It is safe and effective to close PDA through simple venous approach. The retrograde femoral artery approach has the advantage of simplifying the surgical procedure for PDA with small diameters.

Research progress on efflux pump inhibitors of Mycobacterium tuberculosis in recent years / 药学学报

Currently, the resistance of first-line anti-tuberculosis drugs has made the prevention and treatment of tuberculosis increasingly difficult, posing a serious threat to global public health. Several studies have shown that efflux pumps are one of the important causes for bacteria to develop multi-drug resistance and extremely-drug resistance, and efflux pump inhibitors can inhibit the efflux of antibacterial drugs, thereby reducing bacterial drug resistance. Numerous natural products and synthetic compounds have been reported to possess efflux pump inhibitory activity, but they have not been applied in clinical settings because of their toxicity, pharmacokinetic properties, etc. Therefore, we summarized the efflux pump inhibitory activity, antimicrobial activity, and structure-activity relationships of reported efflux pump inhibitors against Mycobacterium tuberculosis in recent years, providing references for the development of new efflux pump inhibitors with better activity and lower toxicity.

Recent progress in delivery systems for photosensitizers and anti-cancer photodynamic therapy / 药学学报

Photodynamic therapy (PDT) is a new modality for cancer therapy, which has been used in the clinical treatment for various tumors, such as skin cancer, bladder cancer and prostate cancer. Most photosensitizers have the disadvantages of hydrophobic, low bioavailability and the limited tumor targeting ability. The nanoscale delivery systems can improve the solubility of photosensitizers and enhance their accumulation at the tumor sites. The multifunctional nano-delivery systems are prepared in combination with other anti-tumor drugs to enhance the anti-tumor effect. In addition to addressing the issues of poor solubility and the insufficient tumor targeting ability, the nanoscale delivery systems need to improve the pharmacokinetic properties of photosensitizers, facilitating their rapid accumulation at the tumor sites and quick elimination in vivo, and reducing the skin phototoxicity. This review summarizes the recent clinical application of PDT of cancer, the development of photosensitizers, the delivery systems for photosensitizers and the combinatorial application with other therapeutic methods. The goal is to present an understanding of knowledge on the design of new types of photosensitizers and its clinical application in PDT of cancer.

Individualized red-cell transfusion strategy for non-cardiac surgery in adults: a randomized controlled trial / 中华医学杂志(英文版)

BACKGROUND@#Red-cell transfusion is critical for surgery during the peri-operative period; however, the transfusion threshold remains controversial mainly owing to the diversity among patients. The patient's medical status should be evaluated before making a transfusion decision. Herein, we developed an individualized transfusion strategy using the West-China-Liu's Score based on the physiology of oxygen delivery/consumption balance and designed an open-label, multicenter, randomized clinical trial to verify whether it reduced red cell requirement as compared with that associated with restrictive and liberal strategies safely and effectively, providing valid evidence for peri-operative transfusion.@*METHODS@#Patients aged >14 years undergoing elective non-cardiac surgery with estimated blood loss > 1000 mL or 20% blood volume and hemoglobin concentration <10 g/dL were randomly assigned to an individualized strategy, a restrictive strategy following China's guideline or a liberal strategy with a transfusion threshold of hemoglobin concentration <9.5 g/dL. We evaluated two primary outcomes: the proportion of patients who received red blood cells (superiority test) and a composite of in-hospital complications and all-cause mortality by day 30 (non-inferiority test).@*RESULTS@#We enrolled 1182 patients: 379, 419, and 384 received individualized, restrictive, and liberal strategies, respectively. Approximately 30.6% (116/379) of patients in the individualized strategy received a red-cell transfusion, less than 62.5% (262/419) in the restrictive strategy (absolute risk difference, 31.92%; 97.5% confidence interval [CI]: 24.42-39.42%; odds ratio, 3.78%; 97.5% CI: 2.70-5.30%; P <0.001), and 89.8% (345/384) in the liberal strategy (absolute risk difference, 59.24%; 97.5% CI: 52.91-65.57%; odds ratio, 20.06; 97.5% CI: 12.74-31.57; P <0.001). No statistically significant differences were found in the composite of in-hospital complications and mortality by day 30 among the three strategies.@*CONCLUSION@#The individualized red-cell transfusion strategy using the West-China-Liu's Score reduced red-cell transfusion without increasing in-hospital complications and mortality by day 30 when compared with restrictive and liberal strategies in elective non-cardiac surgeries.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT01597232.

OShnscc: a novel user-friendly online survival analysis tool for head and neck squamous cell carcinoma based on RNA expression profiles and long-term survival information / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Head and neck squamous cell carcinoma (HNSCC), as the most common type (>90%) of head and neck cancer, includes various epithelial malignancies that arise in the nasal cavity, oral cavity, pharynx, and larynx. In 2020, approximately 878 ‍ 000 new cases and 444 000 deaths linked to HNSCC occurred worldwide (Sung et al., 2021). Due to the associated frequent recurrence and metastasis, HNSCC patients have poor prognosis with a five-year survival rate of 40%-50% (Jou and Hess, 2017). Therefore, novel prognostic biomarkers need to be developed to identify high-risk HNSCC patients and improve their disease outcomes.

Research on the current situation and development direction of male nurses in Dalian / 中国实用护理杂志

Objective:To understand the current situation of male nurses in Dalian area and explore its future development direction.Methods:From August to September in 2020, 189 male nurses who had been engaged in clinical nursing for more than one year in 29 hospitals in Dalian were selected by convenient sampling method, and they were investigated by questionnaire. SPSS 25.0 software was used for statistical analysis. The counting data were described by rate or constituent ratio. Logistic regression analysis was used to analyze the important factors influencing male nurses′ willingness to change profession.Results:A total of 189 male nurses were investigated, 137 of them were under 30 years old, accounting for 72.5%. They had high education background and low professional title, mainly concentrated in ICU, operation room and emergency department of public owned 3A or 3B hospitals, with a monthly income of 3 000 to 8 000 yuan. 33 nurses(17.5%) chose nursing profession because they couldn′t change careers by profession adjustment. 135 nurses (71.4%) considered that work pressure was high. 70 nurses (37.0%) had the idea of changing careers. The main influencing factors included:nursing career was not in accordance with individual interest, dislike of female boss, low income. The prominent problem in nursing career was "inconvenience in gender""the confusion of self-positioning".Conclusions:The hospital should improve the income of male nurses, reduce the work pressure, establish magnetic hospital, establish career planning for them, and expand the team of male nurses. Male nurses should take the initiative to improve their professional ability and professional title, so as to provide necessary conditions for the realization of nursing managers, educators, researchers and other professional goals.

Application of programmed nursing in cardiopulmonary bypass cardiac surgery / 中国实用护理杂志

Objective:Study the application of programmed nursing in the cooperation of cardiopulmonary bypass surgery.Methods:From January 2018 to December 2018, 111 consecutive patients undergoing elective cardiopulmonary bypass cardiac surgery in Dalian Municipal Central Hospital were selected as the research objects. According to the random number table method, they were divided into two groups. 54 cases in the control group and 57 cases in the study group.The control group adopted the routine intraoperative care model, and the observation group was adopted the nursing of cardiac surgery under programmed cardiopulmonary bypass. The mechanical ventilation time, operation time, hospitalization time, incidence of adverse events of intraoperative nursing and complications were compared between the two groups.Results:The operation time, mechanical ventilation time and hospitalization time in the study group were (152.89 ± 18.10) min, (8.30 ± 2.27) h and (11.75 ± 2.54) d respectively, which were less than those in the control group (182.04 ± 18.39) min, (11.72 ± 2.93) h and (14.26 ± 2.97) d, and the difference was statistically significant ( t=8.41, 6.91, 4.78, all P<0.05). There were 8 cases of intraoperative nursing adverse events in the control group and no intraoperative adverse events in the study group, the difference was statistically significant ( χ2=9.03, P<0.01). All patients had no two or more complications at the same time. There were 3 cases (5.26%) of postoperative complications in the study group, lower than 14 cases (25.92%) in the control group, the difference was statistically significant ( χ2=9.03, P<0.05). Conclusions:In cardiopulmonary bypass surgery, programmed nursing can effectively reduce the operation time and hospitalization time, reduce the incidence of adverse events and postoperative complications, improve the efficiency of the operation.

Management experience of brain metastasis after liver transplantation for hepatocellular carcinoma / 中华器官移植杂志

Objective:To explore the pathogenesis and prognostic factors of brain metastasis of hepatocellular carcinoma(HCC)after liver transplantation(LT).Methods:Retrospective review was performed for 17 HCC cases with brain metastasis after liver transplantation from 2000 to 2020.All cases were diagnosed as hepatitis B cirrhosis complicated with HCC.All of them were beyond the Milan Criteria.The immunosuppressive regimen consisted of baliximab + mycophenolate mofetil + calcineurin inhibitors(CNIs)+ corticosteroids in early postoperative period with a gradual tapering of corticosteroids and mycophenolate mofetil.Three patients received sirolimus immunotherapy after tumor recurrence and withdrew CNIs.One of three cases received sorafenib.Results:Other organ involvements included lung metastasis( n=16, 94.1%), bone metastasis( n=5, 29.4%)and liver metastasis( n=6, 35.3%). The median survival time after brain metastasis was 7 months and the 1-year cumulative survival rate 29.4%.The median survival time post-LT was 14 months and the 1-year cumulative survival rate 64.7%.Among 7 patients with a resection of brain metastasis, two deaths at Month 1 post-operation were due to cerebral hemorrhage.The longest survival time was 214 months and the median survival time 9 months. Conclusions:The prognosis of brain metastasis post-LT remains poor.However, early detection and reasonable treatment can prolong patient survival time and even achieve long-term survival.Most brain metastases are accompanied by lung metastases.And the finding of lung metastatic tumor hints at a presence of intracranial lesions.

A prospective multicenter randomized non-inferiority clinical trial study of a domestic disposable digital flexible cystoscope versus a reusable Olympus digital flexible cystoscope / 中华泌尿外科杂志

Objective:To investigate the availability and safety of a domestic disposable digital flexible cystoscope compared with a reusable Olympus digital flexible cystoscope in cystoscopy and removal of double J stent.Methods:From August 2018 to March 2019, patients were enrolled in this prospective, open, multicenter, randomized, parallel positive controlled clinical trial study, which were from department of Urology in Renmin Hospital of Wuhan University, the First Affiliated Hospital of Xiamen University and the First Affiliated Hospital of Guangzhou Medical University. The experimental group and control group were assigned into a 1∶1 ratio by random table method. Inclusion criteria included age≥18 years and have indications for cystoscopy or removal of double J stent. Exclusion criteria included patients having acute genitourinary tract infection, having tuberculous bladder contracture, bladder capacity less than 50ml, having urethrostenosis, female menstrual period, pregnancy and lactation, having difficulty for lithotomy position, having serious cardio-cerebrovascular disease and liver or kidney dysfunction. A domestic disposable digital flexible cystoscope was adopted in the experimental group, whereas a reusable Olympus digital flexible cystoscope was used in the control group. Acceptability of image was defined as primary availability indicator, while success rate of working and performance score were defined as secondary availability indicators and mean operating time was calculated for cystoscopy only and cystoscopy plus removal of double J stent respectively, yet rate of adverse event as well as rate of equipment defects were sorted as safety indicators.Results:A total of 188 cases which were listed in per protocol set completed the clinical trial study successfully. There were 95 cases in the experimental group and 93 cases in the control group. Acceptability of image was 93.68%(89/95) and 96.77%(90/93) respectively in two groups( P=0.52). Success rate of working was 100.00%(95/95) and 98.92%(92/93) respectively in two groups ( P=0.49). Performance score was 14.41±0.93 and 14.56±0.84 respectively in two groups ( P=0.23). Mean operating time (MOT) only for cystoscopy was (15.3±2.6) min and (15.4±3.3)min respectively in two groups ( P=0.93), while MOT for cystoscopy plus removal of double J stent was (21.0±3.2) min and (21.7±3.9) min respectively in two groups ( P=0.69). Rate of adverse event was 8.42%(8/95) and 9.68%(9/93) respectively in two groups( P=0.76). There was no equipment defects in both groups. Conclusions:There is no statistical difference in acceptability of image, success rate of working, performance score, mean operating time for cystoscopy or removal of double J stent, rate of adverse events and rate of equipment defects. A domestic disposable digital flexible cystoscope has shown non-inferiority in the availability and safety compared with a reusable Olympus digital flexible cystoscope.

Cesarean section under spinal anesthesia seven years after heart-lung transplantation: a case report / 中华围产医学杂志

This article reported a successful cesarean section performed on a woman with 37 +6 weeks of gestation after heart-lung transplantation (HLTx) at the Second Xiangya Hospital of Central South University. The patient was a 29-year-old woman with singleton pregnancy who underwent HLTx seven years ago. During pregnancy, she was treated with azathioprine and tacrolimus to suppress immune rejection. The patient was in New York Heart Association (NYHA) class Ⅰ and had no fever or shortness of breath. Prenatal examinations indicated that the mother and the fetus were in good condition. A baby girl was delivered successfully at full term by a transverse lower-segment cesarean section under spinal anesthesia. Both the mother and the child were healthy at follow-up of 42 d after discharge.

Characteristic manifestations of ΔCT in hepatitis B cirrhosis with upper gastrointestinal bleeding and establishment of a predictive model / 临床肝胆病杂志

Objective To investigate the CT characteristics of hepatitis B cirrhosis, and to predict the risk of bleeding by establishing a predictive model for upper gastrointestinal bleeding in liver cirrhosis. Methods A retrospective analysis was performed for the clinical data of 101 patients with hepatitis B cirrhosis who were admitted to Tianjin First Central Hospital from January 2015 to June 2021, and these patients were divided into upper gastrointestinal bleeding group and non- bleeding group. The two groups were compared in terms of laboratory findings and CT values in plain scan, arterial phase, portal vein phase, and venous phase measured by contrast-enhanced CT, and the changes in CT values (ΔCT) across different phases were calculated. The t -test or the Mann-Whitney U rank sum test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. Logistic regression analysis was used to predict the related risk factors; The discrimination of the model was evaluated by calculating the area under the working characteristic curve of the subjects, and the model calibration criteria were determined by Hosmer-lemeshow. Based on the results of multivariate logistic regression analysis, Rstudio4.1.2 R package was used to establish a predictive model, and draws the corresponding ROC curve, calibration curve and clinical decision curve. Results There were significant differences in serum TBil, WBC and PLT levels between the non-bleeding group and the bleeding group (all P < 0.05). There were significant differences in liver-plain, spleen-P-plain and spleen-P-A ΔCT(all P < 0.05). The univariate logistic analysis showed that there were significant differences in leukocytes (odds ratio [ OR ]=0.770, 95% confidence interval [ CI ]: 0.624-0.952, P =0.016), platelets ( OR =0.979, 95% CI : 0.965-0.994, P =0.006), liver plain scan ( OR =1.142, 95% CI : 1.058-1.233, P =0.001), ΔCT value of the spleen from portal vein phase to plain scan ( OR =0.979, 95% CI : 0.959-1.000, P =0.050), and ΔCT value of the spleen from portal vein phase to arterial phase ( OR =0.979, 95% CI : 0.944-0.994, P =0.015) between the hepatitis B cirrhosis patients with upper gastrointestinal bleeding and those without bleeding. The multivariate logistic analysis showed that platelets ( OR =0.968, 95% CI : 0.944-0.993, P =0.011), liver plain phase ( OR =1.148, 95% CI : 1.047-1.259, P =0.003), and ΔCT value of the spleen from portal vein phase to arterial phase ( OR =0.951, 95% CI : 0.908-0.995, P =0.030) were independent risk factors for upper gastrointestinal bleeding. A predictive model for upper gastrointestinal bleeding in hepatitis B cirrhosis was established based on the results of the multivariate logistic analysis, and a calibration curve was plotted. This model had an area under the receiver operating characteristic curve of 0.801 at the cut-off value of 0.433, with a sensitivity of 81.4% and a specificity of 77.6%. The calibration curve of the model fitted well with the ideal curve. Conclusion There are special ΔCT changes in hepatitis B cirrhosis, and the predictive model based on ΔCT has a good predictive ability for upper gastrointestinal bleeding in patients with hepatitis B cirrhosis.

Clinical characteristics and genetic analysis of a neonate with Smith-Magenis syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical features and genetic etiology for a neonate with Smith-Magenis syndrome (SMS).@*METHODS@#Copy number variation sequencing (CNV-seq) was applied to the neonate and his parents, and the genotype-phenotype correlation was analyzed.@*RESULTS@#On the second day after birth, the neonate had presented with pathological jaundice and immunodeficiency. Cranial MRI revealed ventricular enlargement and enlargement of cisterna magna. At 3 months, the infant has presented with square face, prominent forehead, deep-set eyes, hypertelorism, palpebral fissure upward and button noses. Genetic testing showed that he had carried a 2.9 Mb deletion in 17p11.2 region, seq[GRCh37] del(17)(p11.2)(chr17:16 836 379-19 880 992). The same deletion was not found in either parent.@*CONCLUSION@#SMS is mostly diagnosed in child and adulthood, but rarely in neonates. For neonates with SMS, the neurological and behavioral abnormalities have not been shown, but pathological jaundice, CNS abnormalities and immune deficiency may be the characteristics, which require attention of neonatal physicians.

The effect of age and abstinence time on semen quality: a retrospective study / 亚洲男科学杂志(英文版)

This study analyzed the effects of male age and abstinence time on semen quality and explored the best abstinence time for Chinese males among different age groups. Semen parameters, including sperm kinetics, morphology, and DNA fragmentation index (DFI), were reviewed from 2952 men. Samples were divided into six age groups (≤25 years, 26-30 years, 31-35 years, 36-40 years, 41-45 years, and >45 years) and were divided into six groups according to different abstinence time (2 days, 3 days, 4 days, 5 days, 6 days, and 7 days). The differences in semen quality between the groups were compared, and the effect of age and abstinence time on semen quality was analyzed. Significant differences were observed in semen volume, progressive motility (PR), and DFI among the age groups (all P < 0.05), and no significant differences were observed in sperm morphological parameters (all P > 0.05). There were significant differences in semen volume, PR, and DFI among different abstinence time groups (all P < 0.05) and no significant differences in sperm morphological parameters (all P > 0.05). Pearson analysis showed that male age and abstinence time were both significantly correlated with sperm kinetics and DFI (both P < 0.05), while no significant correlation was found with sperm morphological parameters (all P > 0.05). The box plots and histograms of men's age, abstinence time, and semen quality show that most semen quality parameters differ significantly between the 2 days and 7 days abstinence groups and other groups at different ages. Except for the sperm morphology parameters, sperm kinetic parameters and sperm DFI are linearly related to male age and abstinence time.

Research on inheritance of Professor WANG Jie's Experience in Treatment of Frequent Ventricular Premature Complexes Based on Inheritance Support System of Traditional Chinese Medicine / 中国实验方剂学杂志

Objective:With the aid of the Inheritance Support System of Traditional Chinese Medicine V2.5 （TCMISS V2.5），to study the experience and prescription rules of professor WANG Jie in the treatment of frequent ventricular premature complexes，and inherit his clinical experience in diagnosis and treatment. Method:Professor WANG Jie's medical records and prescriptions for frequent ventricular premature complexes from 2016 to 2020 were collected and sorted out. Improved mutual information method，association rules，complex system entropy clustering，and unsupervised entropy hierarchical clustering were used to analyze the nature and flavor，channel tropism，concerted application rules，pair and combination of herbs for statistics， association rules analysis and discovery of new prescriptions. Result:A total of 122 prescriptions of professor WANG Jie on the treatment of frequent ventricular premature complexes were collected. 110 herbs，mostly with pungent and sweet flavors，were mainly on spleen channel and also on heart，kidney，liver，lung，and stomach channels. Cinnamomi Ramulus，Paeoniae Alba Radix<italic>，</italic>Os Draconis<italic>，</italic>Ostreae Concha<italic>， </italic>Glycyrrhizae Radix<italic>，</italic>and Jujubae Fructus<italic> </italic>had the highest frequency in use. The high-frequency herbal pair was Cinnamomi Ramulus-Paeoniae Alba Radix（116 times， accounting for 95.08%），the commonly used corner drugs were Cinnamomi Ramulus<italic>-</italic>Os Draconis<italic>-</italic>Ostreae Concha<italic> </italic>（108 times，88.52%），Cinnamomi Ramulus<italic>-</italic>Paeoniae Alba Radix<italic>-</italic>Ostreae Concha （106 times， 86.89%），Cinnamomi Ramulus<italic>-</italic>Paeoniae Alba Radix<italic>-</italic>Os Draconis （106 times，86.89%）. Commonly used herbal pair was<italic> </italic>Aucklandiae Radix-Amomi Villosi Fructus. The core prescription herbs included Cinnamomi Ramulus<italic>-</italic>Paeoniae Alba Radix<italic>-</italic>Os Draconis<italic>-</italic>Ostreae Concha<italic>-</italic>Glycyrrhizae Radix<italic>-</italic>Jujubae Fructus<italic>-</italic>Zingiberis Recens Rhizoma<italic>-</italic>Achyranthis Bidentatae Radix<italic>-</italic>Codonopsis Radix<italic>-</italic>Astragali Seu Hedysari Radix<italic>-</italic>Cistanches Herba-Poria<italic>-</italic>Ziziphi Spinosae Semen. Conclusion:Professor WANG Jie's prescription for the treatment of frequent ventricular premature complexes is Guizhi Jia Longgu Mulitang，and the main herbs are Cinnamomi Ramulus，Paeoniae Alba Radix，Os Draconis，Ostreae Concha，Glycyrrhizae Radix，and Jujubae Fructus. The final prescription could be adjusted according to the diseases and symptoms of patients.